ArticleThe British journal of psychiatry : the journal of mental science2019
Changes in prescribing for bipolar disorder between 2009 and 2016: national-level data linkage study in Scotland.
Article in The British journal of psychiatry : the journal of mental science, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
30 citing papers in PubMed, 3 syntheses or guidelines pooled it, 71 citations in OpenAlex.
- Temporal trends in associations between severe mental illness and risk of cardiovascular disease: A systematic review and meta-analysis.PLoS medicine · 2022Pooled it
- Lamotrigine in the maintenance treatment of bipolar disorder.The Cochrane database of systematic reviews · 2021Pooled it
- Efficacy and tolerability of atypical antipsychotics for acute bipolar depression: a network meta-analysis.BMC psychiatry · 2021Pooled it
- Time to lithium: A case register study of lithium initiation in bipolar disorder.Journal of psychopharmacology (Oxford, England) · 2026Article
- Trends in the Use of Atypical Antipsychotics Among Children and Adolescents With Bipolar Spectrum Disorders in Korea.Bipolar disorders · 2026Article
- Article
- A qualitative exploration of perspectives on taking lithium supplements.Therapeutic advances in psychopharmacology · 2026Article
- A profile of psychotropic medication in bipolar patients of reproductive age.The South African journal of psychiatry : SAJP : the journal of the Society of Psychiatrists of South Africa · 2026Article
- Twenty-four years of prescription patterns in bipolar disorder inpatients with vs without lithium: a pharmacoepidemiological analysis of 8,707 cases in German-speaking countries.International journal of bipolar disorders · 2025Article
- Attitudes toward lithium prescription among psychiatrists in Saudi Arabia: a cross-sectional study.Frontiers in psychiatry · 2025Article
- Twenty-Three Years of Declining Lithium Use: Analysis of a Pharmacoepidemiological Dataset from German-Speaking Countries.Pharmacopsychiatry · 2024Article
- Mortality risk and mood stabilizers in bipolar disorder: a propensity-score-weighted population-based cohort study in 2002-2018.Epidemiology and psychiatric sciences · 2024Article
- International Trends in Lithium Use for Pharmacotherapy and Clinical Correlates in Bipolar Disorder: A Scoping Review.Brain sciences · 2024Article
- Why is lithium [not] the drug of choice for bipolar disorder? a controversy between science and clinical practice.International journal of bipolar disorders · 2024Review
- Effects of Exercise on Functional Recovery in Patients with Bipolar Depression: A Study Protocol for a Randomized Controlled Trial.Metabolites · 2023Article
- Countering the declining use of lithium therapy: a call to arms.International journal of bipolar disorders · 2023Review
- Clinicians' preferences and attitudes towards the use of lithium in the maintenance treatment of bipolar disorders around the world: a survey from the ISBD Lithium task force.International journal of bipolar disorders · 2023Article
- Pramipexole Augmentation for Treatment-Resistant Unipolar and Bipolar Depression in the Real World: A Systematic Review and Meta-Analysis.Life (Basel, Switzerland) · 2023Review
- A retrospective study of psychotropic drug treatments in bipolar disorder at acute and maintenance episodes.Frontiers in psychiatry · 2023Article
- Demographic and clinical characteristics of lithium-treated older adults with bipolar disorder.Acta psychiatrica Scandinavica · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundPeople with bipolar disorder typically require long-term pharmacological treatment to prevent episodes of depression or mania. However, evidence-based guidelines are often not followed by prescribers and, in some countries, prescribing of lithium is in decline. Polypharmacy is also common in bipolar disorder.AimsTo employ a data linkage approach to describe and evaluate prescribing patterns in bipolar disorder in Scotland between 2009 and 2016.
methodBy linking prescribing data to the electronic Scottish Morbidity Records, we identified a cohort of 23 135 patients with bipolar disorder who were prescribed psychotropic medication between 2009 and 2016. We examined trends in proportions of patients prescribed each of six drug categories. Random effects logistic models examined change in prescribing over years of interest.
resultsThe most common form of treatment was antidepressant monotherapy (24.96%), with only 5.90% of patients receiving lithium monotherapy. Prescribing of antipsychotics and anti-epileptics increased from 2009 to 2016 (antipsychotics: odds ratio 1.16, 95% CI 1.15-1.18; anti-epileptics: odds ratio 1.34, 95% CI 1.32-1.36), whereas prescribing of lithium decreased (odds ratio 0.83, 95% CI 0.82-0.85). Prescribing of valproate decreased from 2009-2016 in women, but increased in men (women: odds ratio 0.93, 95% CI 0.90-0.97; men: odds ratio 1.11, 95% CI 1.04-1.18).
conclusionsAntidepressant monotherapy was the most common form of treatment for bipolar disorder in Scotland and prescribing of lithium has declined between 2009 and 2016. The findings are concerning and represent a gap between treatment guidelines and clinical practice.Declaration of interestNone.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.